Influence of Acupuncture on the Outcomes of in Vitro Fertilisation When Embryo Implantation Has Failed: A Prospective Randomised Controlled Clinical Trial

Abstract

Objective To evaluate the effectiveness of acupuncture and moxibustion as an adjuvant treatment in women undergoing in vitro fertilisation (IVF) when embryo implantation has failed. Methods A prospective, randomised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF. The patients were randomised in three groups: control (n=28), sham (n=28) and acupuncture (n=28). The sample size was calculated by assuming a pregnancy rate of 10% when embryo implantation had failed. The pregnancy rates of the current IVF cycle were evaluated by measurement of blood β human chorionic gonadotrophin (βhCG) and subsequent transvaginal ultrasound. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before ovarian puncture and on the day after embryo transfer. In the acupuncture group, patients were treated with moxibustion at nine acupuncture points (BL18, BL22, BL23, BL52, CV3, CV4, CV5, CV7, GV4) and needling at 12 points. In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points. Results The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7% vs 7.1% vs 10.7%; p=0.0169). Conclusions In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.

The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis

“…The characteristics of the included trials are summarized in table 2. Acupuncture at follicle phase only was used in 2 of the trials [29,30], while the other 2 trials used acupuncture at follicle phase and around ET [31,32]. All 4 trials were published as full reports - 1 in the UK [31], 1 in Australia [32] and 2 in China [29,30].…”

“…Brenner [40] stated that this is a widespread issue with acupuncture trials as a one-size-fits-all protocol; these trials only give information on that protocol and not on the possibility of success with acupuncture. In the study of di Villahermosa et al [31], acupuncture was performed on the 1st and 7th day of ovulation induction, on the day before ovarian puncture and on the day after ET. The study showed that the CPR in the acupuncture group was significantly higher than that in the control and sham groups.…”

Effect of Transcutaneous Electrical Acupuncture Point Stimulation on Endometrial Receptivity in Women Undergoing Frozen-Thawed Embryo Transfer: A Single-Blind Prospective Randomised Controlled Trial

“…6 7 Successful implantation depends on a synchronised dialogue between high quality blastocysts and a receptive endometrium. 8 Different strategies have been developed to assess endometrial receptivity including measurement of endometrial cytokines and ultrasound examination. The HOXA10 gene codes for a transcription factor that functions as a regulator of uterine organogenesis during the embryonic period.…”

Somatosensory Stimulation and Assisted Reproduction

“…In support of this assumption, acupuncture has been shown to increase endometrial thickness compared with sham acupuncture and standard care. 44 However, Shuai et al 48 are the first to have shown positive effects on contemporary ultrasound markers of endometrial receptivity (three-dimensional endometrial and subendometrial vascularisation index and presence of a triple-line pattern) plus HOXA10 protein expression, a novel molecular marker. Interestingly, all these studies have used serial treatments that incorporate the follicular phase of the cycle.…”